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F. Quhill, S. Pushpoth, S. Mirza, A. Hardwick, Y. Yang; Ocular Decompression Pre-Intravitreal Injection Can Reduce the Magnitude of Postoperative Iop Spike. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5610. doi: https://doi.org/.
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To assess the effectiveness of Honan Balloon tamponade, pre-intravitreal injection, in reducing the magnitude of post-injection IOP spike.
This was a randomised, single masked, two arm study. Thirteen eyes were recruited into the control arm, and ten eyes to the interventional arm. The interventional arm received a 5-minute ocular decompression with the Honan Balloon pre-injection, set at 30mmHg. The control arm received an intravitreal injection as normal with no pressure lowering manoeuvres.Patients were allocated to the two arms on an alternate basis as they presented to the Macular department at the Wolverhampton Eye Infirmary for intravitreal injection of Ranubizamab (Lucentis).IOP was measured in both groups pre-op and 60 minutes postop by a single masked observer. Injecting physicians were not involved in IOP measurement at any stage, and all eyes were injected with the standard volume of 0.05ml.Difference between two group means was tested for statistical significance using student t-test.
For the balloon group, change in IOP ranged from -7 to +7 mmHg (mean = +0.8). The control arm had post-injection IOP ranging from -1 to +20mmHg (mean = +6.8). The difference between mean post-IOP spikes was statistically significant (p < 0.005).
Ocular decompression pre-intravitreal injection is an effective manoeuvre in reducing the magnitude of IOP spike post-injection. This additional step will further enhance the safety of this procedure of drug delivery.
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